Men's Health Blog

Monday, November 2, 2009

The media have frightened men. We're told, in no uncertain terms, that once we're into our late 30s, sex is downhill. We can't perform as well as younger men, we're not as attractive as younger men, and our potency will continue to decline until--when we reach our late fifties--we will be almost non-sexual.

What bunk--but powerful bunk it is. Like women and menopause, older men face dozens of unfounded fears--usually categorized by the dreaded "mid-life" crisis.

Yes, there are physical changes that occur as men age, but these changes do not adversely affect sexuality or the ability to have sex. But if you are silly enough to buy into the myth of the impotent middle aged male, then and only then will you have some problems.

In general, as men age it may take a little longer to achieve an erection. This slightly slowed response is meaningless-yet it frightens men because they see it as an indicator of declining sexual ability. It is nothing of the sort. This SLIGHTLY slowed response means nothing--it does not indicate the beginning of impotence nor does it mean that sexual desire is waning. It means only that you are aging naturally and gracefully. Instead of instant erection, it now takes a minute or two. That's meaningless in the grand scheme of things, unless you think sex is supposed to be completed in a matter of minutes. In fact, this slowed response means that men need foreplay, just as women do. This can be a blessing to your partner and to you. Enjoy the extra time--be creative, relax.

As men reach their late fifties and early sixties, it's possible that the erection may not be as hard or as large. But once fully excited, the erection will most likely be hard and steady. Many men find that manual stimulation by their partner is needed to gain a full erection. There's nothing wrong with that--both partners can enjoy the experience.

As men age, there's likely to be a reduction in the amount of seminal fluid, but this, too, is meaningless. And, in fact, it may be a bonus. Less seminal fluid usually means that men can delay ejaculation for a longer period of time. Again, this benefits both partners. It's common for the length of love making to increase as men age. There's absolutely nothing wrong with that.

Some men worry that their orgasms become less powerful with age. In some cases this may be true, but less powerful does not mean less enjoyable. And men will notice that it takes longer to have another erection after orgasm. As teenagers, it may take a matter of minutes after orgasm; in their forties, many men find it takes a matter of hours. In your seventies it may take a few days. But this increase in time in no way reflects a loss of potency, a decline in sexuality, or a loss of sexual drive.

And here's an important point: lovemaking does not always have to involve ejaculation. As we age both men and women realize that there are other parts to making love other than orgasm. Don't limit your lovemaking only to those times when ejaculation is possible. Experiment, have fun, there's lots to do once the pressure of performance is lifted.

Many men have fallen victim to the myth of male menopause. There is no such thing.

As we know, the female body will begin producing less estrogen as menopause begins. The male body, however, continually produces testosterone--the male hormone--throughout a lifetime. Earlier studies showing a decrease in testosterone as men age were flawed. If there is a reduction it is usually caused by health problems--obesity, smoking, emotional problems. Men do not face a male menopause--it's as simple as that.

Impotence

Male sexual performance is fragile. If it depended only on physical abilities, sexuality would be an easy thing. But for the man, physiology must be combined with psychology. It's the delicate balance of brain and body which makes sexuality so intriguing, and for many men, so problematical.

Impotence is spreading in America. Some say the reason is the rise of the assertive female--the women's movement has frightened men, leaving them unsure of their role in today's sexual adventure, and thus unable to perform with any degree of regularity.

Others agree the women's movement has played a part, but argue that it's the female's fault that American males face impotence. The women's movement, so the argument goes, has emasculated men. In their rush to equality women have debased masculinity--transforming the positive qualities of men, attributes like passion, enthusiasm, drive, into negatives attributes. The argument goes that men no longer can be themselves, and in trying to affect a false persona men have lost their sexuality.

But to blame the rise of impotence either directly or indirectly on women is unfair. Just as serious illness is on the rise in America, so are hidden conditions like impotence and frigidity. Ours is a fast paced world. We work more hours than did our parents; competition for good jobs is tougher than ever; the pressure to make money, to be a success has never been greater. Now add to these pressures the problem of sexual relations in the 1990s--choosing the wrong partner might not only mean a broken heart, it could mean an agonizing death at the hands of the mutating AIDS virus. It's not hard to understand why impotence, which is so dependent on psychological calm and confidence, is plaguing American men.

Impotence--the inability to get or maintain an erection--threatens a man's self image. Needless to say, impotence strikes fear in the hearts and minds of most men. And it's this fear which makes the condition so insidious. If men would realize that impotence has little to do with sexuality and lots to do with a reduced body function, the problem would be a long way toward being solved. Unfortunately, men see impotence as a challenge to their manhood--to the very core of their nature. For this reason, one sudden bout of impotence--which is, by the way quite natural--is suddenly turned into a fearful event. This fear creates another episode, the fear grows, then another. Soon the once instance is turned into a seemingly permanent condition.

To fight impotence what's needed is knowledge--knowledge of the cause and information about possible solutions. In the vast majority of cases, impotence can be quickly corrected. Only those cases involving a physical disability or a serious mental condition will not respond to some common sense treatment.

To begin, you must know that an occasional episode of impotence is perfectly normal. It happened to Don Juan as it will happen to almost all men. The reason is unknown. The situation could be ideal, the partner could be right, but somehow the body and/or the mind don't respond. Remember, an occasional episode means nothing--you're not losing your sexual drive. It's something that happens once, then goes away. Recognize it as that, and you'll have no problems. But begin fixating on the one failure, and you're on your way to a real problem.

Also know that a natural decrease in sexual drive will occur with ages. This, too, is normal. The decrease in libido--sexual drive--is slight, and really doesn't come into play until the late 50s or early 60s. Remember, this decrease in libido is a fact of aging, but it in no way diminishes a man's ability to have an erection. Older men can have erections at the same frequency and strength as younger men. So, don't let your decreased sexual drive frighten you into impotence. There's really no correlation.

And don't let age frighten you. So often both men and women assume they're losing sexuality because they're aging. The correlation between sexuality and age has not been made--at least until you enter your 70s or 80s. And even then, you can have a very fulfilling sex life.

Another fact: around age 40, men usually need more physical contact before achieving an erection. At one time it may have been possible to sustain an erection by looking at a beautiful women, once past 40 some contact is needed. Again, this in no way means that you're losing your ability to perform. It's nothing more than a natural change in your sexual appetite.

With this knowledge in hand, you can help increase and restore your sexual ability by trying proven home remedies.

Watch what prescription drugs you are taking: It's estimated that 30% of impotence cases are caused by prescription drugs. Often doctors don't warn their male patients about this possible side effect. If you're taking tranquilizers, even minor ones, your problem is likely drug related. Some prescription antihistamines and muscle relaxers can cause impotence, as can many drugs given to lower blood pressure. Vasodilators and diuretics can have an adverse effect, as well as MAO inhibitors and other anti-depressive drugs. If you're taking any of these kinds of drugs and experiencing impotence see your doctor at once. There's a good chance your problem can be easily corrected.

Quit using drugs: Alcohol, amphetamines, narcotics, even marijuana can cause impotence. The idea of a drink before sex is something best left to the movies, as is the idiotic notion that marijuana somehow makes sex better. It doesn't--in fact, marijuana could make sex impossible.

Lose some weight: If your obese, impotence could become a problem Excess weight strains your system--particularly your circulatory system. Especially in older men, the more weight you carry the more sluggish your circulation. Blood flow is reduced--including blood flow to the penis. The result? Impotence. But be careful: losing too much weight too quickly is harmful to your health, and can also affect sexual performance.

Relax, relax, relax: Tension is the number one killer of sexual desire. How can you perform sexually when your mind is filled with thoughts of work, bills, problems, the kids, you name it? To enjoy sex you must be there--physically and mentally. If tension has you tied in knots, it's a good bet that your sexual performance will be poor, at best. To beat impotence you must beat tension. If it takes meditation, a warm bath, a quick nap, self hypnosis, whatever, you must find a way to relax yourself so you can enjoy sex and life.

Stop blaming yourself: No one asks to become impotent. The condition has any number of causes, none of which is your fault. Nor is it the fault of your partner. Impotence can be solved, but adding blame on top of the guilt and embarrassment only makes things much worse.

Size doesn't count: Many times impotence is caused by embarrassment: men believe they are smaller than normal and this body image problem quickly leads to impotence. Two points to remember: most men are not smaller than average. First, when it comes to penis size the vast, vast majority of men are normal--that is, an erection of five to six inches. It's a good bet that you're average. Don't make the mistake of judging size by what you might see in sexy magazines or movies. Like the women, the men who pose are well above average. Compared to them, you may be small, but compared to most men, you're right on the mark. Second, size has little or no correlation with amount of pleasure a man can give a woman. When it comes to making love, technique and passion are they keys. Size is unimportant.

Analyze your problem: If you've suddenly been experiencing impotence, take a look at lifestyle changes, increases in stress, changes in prescription drugs, increased alcohol use, or anything else which has changed shortly before the problem began. If prescription drugs or alcohol aren't the problem, look to stress enhancers. Have you recently changed jobs? Has your financial situation changed for the worse? Are you long overdo for a vacation?

Exercise for your vital organs: Is there an exercise that can help impotence? Maybe. Something called the Kegel for Men is catching on as a natural way to strengthen erections. The Kegel is easy to do. Squeeze the muscle of your pelvic floor. Where are they? They're the muscles you use when you try to stop the flow of urine. The Kegel uses that same squeezing sensation to strengthen these muscle. Squeeze and hold for three to five seconds. Then release and do again. Try starting at 10 times, three times a day. Eventually work your way to approximately 200 squeezes a day.

Try an herbal solution: Yohimbe has shown particular promise as an herb that can make erections harder and firmer. Studies show that yohimbe, a tree bark extract, has been shown to increase blood flow to the penis. In clinical tests, the active ingredient in yohimbe was tested on a group of men who had been impotent for less than two years.

The study reported an improvement rate of 81% for those taking a moderate dosage of the active ingredient for one month.

More than 60% of men who experienced partial erections and had failed at normal intercourse at least half of the time reported fuller, more lasting erections.

Thursday, October 29, 2009

No one yet fully understands the mechanism by which sexual preference is ultimately determined, and theories cite genetic and environmental factors, with the theories involving primarily genetic factors gaining increasing support, in part based on studies of identical twins. In addition, the fact that many gays appear to have already determined a sexual preference at a very early age supports theories which suggest only a limited role for the environment and family-related factors. The determination of what is arousing and what is not is not a matter of conscious decision.

Gay men are very much like straight men, except for the fact that the sexual arousal mechanism is primarily if not exclusively triggered by persons of the same sex. Gays are just as mystified by why women trigger the arousal mechanism in straights as straights are mystified by why other men trigger the arousal mechanism in gays. From the gay perspective, it is the straight world that is "abnormal." Interestingly, other than for the problems in dealing with discrimination while living as a gay in a predominately straight world, I have yet to visit with a gay man who has expressed an interest in waking up tomorrow morning as a straight. The vast majority of gay men are not in any way dissatisfied with their sexual preference, which these see as the very essence of their being.

Gays are largely mystified as to why they are treated as they are solely on the basis of their sexual preference. Discrimination against and other acts of hatred toward gay men is a sad component of American culture as well as in cultures of many other countries where treatment by the majority can be even worse than it is here. I have a theory that many of the men who discriminate against and otherwise preach hatred toward gays are themselves struggling with their own inner unresolved conflicts with respect to their own sexual orientation. Acting in anger against gays is a way of dealing with their own anger with regard to inner conflicts about their own sexual preference! Those who cite religious and biblical teaching against gays are on shaky ground as well. First, the biblical passages relating to this topic are not at all clear, and can have many different interpretations. The basic message of Christianity deals a lot with topics like acceptance, understanding and love, and speaks out boldly on issues such as hatred and discrimination. How anger and discrimination toward gays can be rationalized on the basis of religious doctrine remains a great mystery to me.

Many of the sexual stereotypes of gay men portrayed in the media--that sexual orientation is almost exclusively a sexual attraction--are inaccurate. Complicated story lines are difficult to follow, particularly in a half-hour television show. Many straights (in part, based on media stereotypes) believe that most gay men are really women living in men's bodies, that is, men who would have preferred to be women, if given a choice. I have found that this characterization, popular in the media, to be a description of only a tiny percentage of gays. The vast majority of gay men are very happy being male, have no interest in dressing or acting like women, or undergoing a sex-change operation. Indeed, from all outward appearances, they are indistinguishable from their heterosexual counterparts--except that their sexual arousal mechanism is triggered by persons of the same sex. In our predominantly heterosexual culture, this one tiny difference presents some major issues for our society. Straights often assume that the behavior of all gays is similar to what they see of a few gays in the news media. The vast majority of gays are living lives very similar to men in the straight culture, holding down stable jobs in all types of work and searching for loving, lifelong relationships with a partner--just as straights attempt to do. In terms of length of a same-sex relationship, the gay men who have written me all seemed to be convinced that their relationship is representative of the group as a whole. I have heard a gay man who has been in stable relationships for 20 years and is convinced that this is quite "average" for gay men of his age and normal. I have heard from another gay men who moved in and out of relationships for 20 years with each relationship only lasting from 6 to 18 months. Interestingly, he was equally convinced that his particular situation represents the "normal" pattern of gay behavior. I conclude that there are no truly reliable data on this. I do believe, however, based on the conversations I have had with gay men, relationships, on average, tend to be much shorter lived than in the straight community, often measured in weeks or months, but usually not in years. There is apparently some research evidence to suggest, however, that the pattern of short-lived relationships tends to recede as gay men age, just as it does among heterosexuals and that the AIDS epidemic has tended to foster a movement toward more long-term, monogamous relationships among gays.

Sexual Preference: Nature or Nurture?Is sexual preference largely determined by genetics, or does the environment (i.e. family upbringing) matter? That is an interesting and important question. Twenty years ago, the vast majority of psychologists believed that the environment under which a child grew up played a major role in determining sexual preference. Distant or absent fathers along with overbearing mothers were often blamed for same-sex preferences of, particularly, male children. These theories of an environmental (family) basis for sexual preference have been increasingly discounted by researchers, as more credence has been placed on genetics. But even if genetics plays a major role in determining ultimate sexual preference, the rules under which the genetics laws must work are not simple. Not too many years ago, the laws governing genetic inheritance were viewed by scientists as very simple, largely following rigid rules laid out by Gregor Mendel, a monk who studied genetics by observing characteristics of successive generations of peas, and other plants. Mendel basically concluded that there were dominant and recessive genes, with dominant genes ruling unless the individual inherited recessive genes from both parents. Individuals with but one dominant gene could still transmit recessive genes to their progeny. The inheritance of eye color is an example, with brown eye color being the dominant trait and blue eyes being recessive. If the individual inherited one gene for brown eyes from either parent, the eye color would be brown. Only if both parents provided the blue, recessive gene, then eye color would be blue. These simple rules apply in most instances. But they did not explain the occasional green-eyed person, or the even rarer exception of people with one brown eye and one blue eye. These exceptions to the rigid laws--situations that didn't quite conform to expectations--were often discounted by scientists as being unimportant. But in recent year, these "sloppy" exceptions to the rules have assumed increasingly importance, as more frequently, exceptions to the established laws were discovered. In many instances, for example, the effect of a recessive gene might not be completely masked by the dominant gene. Or, certain combinations of genes may have impacts on the person intermediate between their individual impacts. Eyes are not only brown or blue--they may be slightly brownish or slightly bluish. Or complicated interactions among several different genes may be involved.

Another controversial illustration is the comparative role of cigarette smoking (an environmental factor) and genetics in the development of lung cancer. Many people who smoke heavily all their lives never develop lung cancer. However, many other smokers die of lung cancer, some at a relatively young age. Those who do not develop lung cancer likely have a genetic factor that protects them, or, alternately, those who develop lung cancer have a genetic factor that interacts with the environmental influence (smoking) to result in lung cancer. No one knows for sure, but clearly, the incidence of lung cancer is likely tied to both genetic and environmental factors.

There is increasing evidence pointing to a genetic basis for sexual preference, but just as in the cancer-smoking connection, that doesn't mean that the role of environmental influences can be completely ruled out. The evidence supporting the genetic basis includes (1) work by researchers pointing to a specific gene identified as present in many, if not most, gay men; (2) studies of identical twins which indicate that if one twin is gay the likelihood of the second twin being gay is increased; and (3) studies suggesting physical differences in brain structure between gays and straights. Interestingly, in the case of the identical twin studies, the probability that the second twin is gay if the first twin is gay is not 1.0, despite the fact that both twins inherited the identical genes from their parents. A simple model would suggest that being straight is the dominant trait (as is having brown eyes) whereas being gay is a recessive trait, from which recessive genes must come from both parents. But that model is far too simple. Only a model that incorporates an incomplete manifestation of genes or complex interaction among genes, would be consistent with all the variations seen in human sexual preference. Further, while there may be a sexual preference programmed into our genetic makeup, the environment could still play a role, just as it likely does in the cigarette smoking-lung cancer connection. A simple Mendel-like model of the inheritance of sexual preference would suggest that nearly everyone would be either straight or gay. In this Mendelian world, virtually all straights would be absolutely disinterested in same-sex activities, and nearly all gays would be totally disinterested in different-sex activities. There would be few, if any, bisexuals. But this does not conform to the real world, and reality instead suggests that there are a lot of people--both men and women, where sexual preference is not clear-cut. In addition, this opens up the possibility that while genetics may be a factor in determining sexual preference, other environmental factors may still play a role, at least for a portion of the population. It is widely believed and probably well documented that men in prisons, students in single-gender schools etc. tend to engage in more same-sex activities than occurs within the population at large. Interest in same-sex versus different-sex activities is likely, in part, determined by the available options, and part by genetic programming. Further, for some individuals, sexual preference is not static but dynamic, with comparative preferences for same-sex versus different-sex activities changing over time. I am aware not only of married men who are seeking to move into a same-sex relationship instead, but also of men with gay partners who are seeking to dissolve the gay relationship and marry a female lover. So making the assumption that for everyone, sexual preference if rigidly preprogrammed and static oversimplifies the case as well. Psychologists have long known that it is possible many individuals who can be aroused by either same-sex or by different-sex relationships to "develop" either the straight or the gay sides of their personalities and have a degree of control over sexual preference. Thus, the basis (cause) for human sexual preference remains marvelously complex and interesting. For a different perspective dealing with some of the same issues see the Council for Responsible Genetics website.

Same-Sex ActivitiesStraight society is often somewhat mystified by the specific sexual activities that gays engage in. Current thinking in psychology is that perhaps as much as one-third of the adult male population has, at one time or another, engaged in some form of same-sex activity leading to orgasm. It's not uncommon, according to psychologists, for boys only recently past puberty to engage in mutual masturbation, or "jerk-off" sessions, with their male friends. Psychologists attach little significance to this sort of same-sex activity in terms of its implications for sexual preference. Psychologists refer to such activity as "incidental homosexuality, and do not necessarily believe that simply because young person, or even an adult man, irregularly engages in such activity that the man is gay.

However, many gay men are also very interested in mutual masturbation sessions where both partners manipulate their own or each other's sex organs. Such activity may involve more than two men. The sex-oriented newsgroups are filled with personal ads from men who are looking for jerk- off partners, and internet newsgroups have largely replace public restrooms for advertising. The true sexual orientation (preference) of many of these men can be ambiguous.

Some men appear to attach no more significance to the activity than, say, going out for beer and a pizza, and simply treat it as an enjoyable way to spend an evening. I've visited with married men who occasionally "go out with the boys" to engage in mutual masturbation. These men claim to very much enjoy sex with their wives as well, have no intentions of leaving their wives, and simply regard the jerk-off sessions as a different and interesting sexual activity. In the instances I am aware of, the wives are unaware of what goes on when the husband has a night out with the boys. Another common activity is watching erotic videotapes while engaging in mutual masturbation by male friends. Oral sex among gay couples is the next step, although even here some psychologists regard the oral sex as simply another manifestation of incidental homosexuality that does not provide sufficient evidence that the men involved are gay.

Anal intercourse is the type of sexual activity many psychologists regard as only taking place between men who are gay. This view, however, is by no means universally held. Some recent research suggests that anal intercourse ranks only third (behind mutual masturbation and oral sex) as the favored activity among gays. Of course, the AIDS epidemic and the subsequent emphasis on safe(r) sex has substantially changed not only the views of gays about activities such as anal intercourse but also the comparative frequency of the various activities, so data collected in recent research may have (undoubtedly has) changed substantially from that collected 5 or 10 years ago. Straights were initially confused by the spread of AIDS within the gay community. Most straights assumed that gays primarily engaged in activities such as mutual masturbation which posed virtually no risk of disease transmission. The speed by which AIDS moved through the gay community strongly suggested to straights that anal intercourse was a favored sexual activity for many, if not most, gays. Why anal intercourse ever assumed such an important role in the gay community remains something of a mystery to me, in particular because the rectum and the penis are not designed to fit together very well. Gay couples have written to me to describe in detail some of the difficulties they were having with anal intercourse and complaining that the sensations they were experiencing in anal intercourse were not very interesting. The rectum is just a hollow tube, and contains no structure that plugs the end as the cervix does in the woman. Still, many gay couples appear to regard anal intercourse as a very necessary part of the relationship. This is the one activity that straight men probably have the most difficulty understanding and dealing with.

Sadly, since anal intercourse is the primary mechanism by which the AIDS virus is transmitted between gays, it is undoubtedly responsible for the vast majority of cases. While the AIDS virus can be transmitted via oral sex, the probability of transmission is very low, and would usually require open sores in the mouth. The rectum is very fragile and is easily torn in anal intercourse. Thus, anal intercourse can provide an excellent path for the transmission of the AIDS virus from semen to blood and from blood to penis. The fact that many gay relationships tend to be fragile and short-lived, that anal intercourse was a favored sexual activity for many gays, and the easy transmission of the AIDS virus through the rectum has in large measure been responsible for the AIDS epidemic among the gay community. There are many sexual activities that gays could (and increasingly do) enjoy which would pose essentially zero risk of disease transmission--mutual masturbation, sex play involving clothing, sex toys and the like.

Male Sexuality Issues in Heterosexual RelationshipsIn sexual pleasure, do relationships matter? Of course! Relationships are not the key to sexual happiness, but for most men, they are certainly a key to sexual happiness. In re-reading this paper, I began to think that many of the discussions contained herein, while accurate, were treating some of the sexuality issues in a relationship void. I do not consider myself to be an expert on relationships. However, I hope that some observations I am making here about relationships might prove useful to others. For both men and women, much of what we learn about the members of he opposite sex is acquired in the early years of post-pubescence, that is, the early teenage years. Much of this information, if not wrong, certainly contains elements of inaccuracy. Teenagers spend a good deal of time not only developing the requisite social skills but also discovering their own and their friends' sexuality. The values and beliefs developed in the teenage years about the opposite sex are often carried into adulthood with little modification. Teenage girls quickly become convinced that teenage boys are constantly thinking about sex. This observation is probably not far from accurate. At the same time, they become convinced that the number one objective of the vast majority of teen-age males is "scoring".

Many teenage males quickly come to the conclusion that the young women expect them to behave this way, and they are often more than happy to comply with these expectations. Somehow, it's unmasculine to not try to encourage a date to have sex. Young women quickly begin to believe that young men, as a group are crude boars, and insensitive to the more subtle parts of a relationship. Early on, young women become convinced that the only part of a relationship that matters to men is the sex part. The notion of sensitivity and caring somehow get lost in the process. So both men and women enter adulthood with some real misconceptions about sexuality and the role of sex in a relationship. Young men often fear that anything that borders on sensitivity will be interpreted as being somehow "unmasculine" and thus represent inappropriate behavior for a "real" man. Women believe that the only part of intimacy that matters to men is the sexual intercourse part,

Some couples never really get beyond these misconceptions. They muddle through life never really getting what either partner wants out of a relationship. Men don't really like being viewed by their partners as insensitive clods, but many do not know where or how to begin to change. Parents often provide role models in this regard, and young men who grew up in a family where the father was sensitive and caring to the needs and wishes of the mother--sexual and non-sexual--are at a great advantage in developing the requisite skills. Young women who have had the advantage of observing their parents loving and sensitive relationship are also at a significant advantage over those who grew up in families where the relationship is weaker or less stable. Why is all of this important? Simply put, sex is a good deal more enjoyable in a loving and caring relationship, and this is true for both men and women. John Gray became a best-selling author with his book Men are from Mars: Women are from Venus. The popularity of this and subsequent books stems primarily from some basic truths Gray was able to articulate so well.

In his book, Gray argues, not surprisingly, that men and women are very different with respect to their sexual and non-sexual needs and desires, and thus bring very different ideas about relationships to the table. Clearly, most men probably see intercourse as being far more important to their overall happiness than most women do. But these differences extend to non-sexual matters as well. Men see themselves as "problem solvers" in a relationship, not as sympathizers. If a women faces a problem involving a co-worker, for example, the male partner (husband), often believes that in order to make the woman feel better, the problem must be solved. In reality, what the woman is often looking for is not a solution to her problem, but rather expressions of caring sympathy. Phrases such as "You were mistreated and I can see why you are angry with the co-worker." may be far more successful than a sincere attempt to try to help her deal with the co-worker. Worst of all is to belittle the problem by saying "I don't think that's serious enough for you to be concerned or upset about it." In a relationship, that kind of help is asking for trouble.

Women often believe the myth that the only thing men enjoy about sex is intercourse. Foreplay is just something men put up with to please the woman. I hope that my foregoing discussions have helped explode that myth. But men believe some myths too. The first myth is that women don't enjoy sex nearly as much as men do, but sometimes "put up with it" to please their partners. It is true that the vast majority of women se the sexual act as part of a "package" deal. Sex is but one of many components of a worthwhile relationship. Most women would probably rate caring and sensitivity in a loving relationship as being far more important than the sex act itself. But its not true that most women feel only so-so about sex. There are many women who see sex as a very important part of the overall package.

So the package deal of a relationship for women involves a lot of things: a loving and caring relationship, perhaps a family, home, a big dining room table--that is, all the signals that suggest a stable, caring and protected environment. With the possible exception of the big dining room table, men want these things in a relationship too. The rankings may be different, but, in general, the same items are "on the list" for men too.

So, what's a man to do? Showing some sensitivity towards the female partner would be a good start. This is why florists have become wealthy selling long-stem roses. This sensitivity is important both in and out of a sexual setting. Strong relationships begin with both partners sending strong signals that they care for each other. Relationships are not built of the sizes of breasts and penises. Most men are far less concerned about breast size than women believe. Analogously, most women are not nearly as concerned about the size of an erect penis as men believe. These are leftover myths from adolescence.

In short, relationships are built on three words: sensitivity, caring and communication. That's how love develops. It's really all quite simple-- but at the same time, marvelously complex. Sex without these three factors is dull and meaningless. So, how does a man show to a woman that he is sensitive and caring. Communications is critical. John Gray is on the right track. A caring relationship is defined by both compassion and concern. Women don't marry men in order to have someone to solve their problems. They are searching for someone who can sympathize with their situation, whatever it is. In addition, expressions that indicate the man is thinking continually about the woman always earn high marks. Women are actually "turned on" by these expressions that indicate a caring love. And the sex will be better because of this. Many men are quite dysfunctional when it comes to revealing a sensitive side. In a sexual relationship, men are often unwilling to talk about what "feels good" to them, or that by asking the woman about what feels good to her, that somehow the myth of the "magnificent lover" will be exploded. Adolescent boys often like to act as if they learned all their was to know about how to make a woman happy at age 15, and frequently bring these views into the adult relationship. I believe that men who are considered by women to be "great lovers" did not achieve this because of their skills at physical techniques. Great lovers become great because they are willing to communicate with women about exactly how they want to be touched without any embarrassment. In this regard, the man who considers himself to be "less experienced" with "more to learn" may actually be more successful in the lovemaking department than the man who claims to already know everything there is to know about lovemaking. The less experienced man will likely want to communicate with his partner on a continuous basis during the lovemaking session. Interestingly, the ability to communicate needs and feelings during intimate sexual activity often helps build better communication skills in non-sexual areas as well, solidifying the relationship in total. At minimum, this is certainly something to ponder. Sex without a caring, loving relationship is no sex at all!

Male Sexuality: Information for Single, Unattached MenThe issue of male sexuality as it relates to single, unattached men who are not having sexual relations with a partner has always been an interesting one to me. Some men are single by choice: others are single as a result of uncontrollable events that have taken place in their lives. Among those who are single by uncontrollable events that have taken place in their lives are those who are divorced or widowed, and some who are disabled. There are also those who for,whatever reason, choose not to find a partner for sexual relations. Some men simply prefer a life of being single and unattached: others choose an occupation such as becoming a Catholic Priest, which requires a vow of celibacy. Being in this situation is a problem only if the man believes it is a problem. I have talked to a lot of single, unattached guys. Most, though not all, view this as a transitory phase of heir lives, and expect to at some future point to find a sexual partner. Some, however, see living single and unattached as essentially a permanent situation, and they have no particular interest in finding a sex partner. Some people might argue that many of those who fall in the latter category have low sex drives, that is, they are not driven by the same sexual chemistry which dominates society, but this is clearly not true in all cases. Another category of men who face an interesting set of issues are those who, by virtue of their occupational choices, must be away from their sexual partner for long periods of time for business or other work related travel. The media stereotype is that many, if not most of these men have sexual partners waiting for them at the locales where they are working away from home. Obviously, this describes the behavior of some men, but not the majority, I believe. I've observed that the vast majority of divorced men quickly enter into a sexual relationship with another woman, this despite the psychological turmoil as a result of the divorce. Very few divorced men remain divorced for very long. However, I've also observed that a significant number of divorced women remain single, far more so than is true for men. While these women may have the opportunity to engage in sexual relations with men while they are single, I'm convinced that the real explanation lies in the differences in how the sex drive works in men versus women. Men are likely to see intercourse as being of major importance to their lives: Women, however, see intercourse as just one component of what a relationship is all about, and if the other components are not there, there is no point in sexual intimacy. So women who do not find the other things they are looking for in a relationship generally stay single. For women, sex is very enjoyable, but not so enjoyable that its worthwhile even when the other conditions necessary for intimacy have not been met. besides, if the other conditions have not been met, sex is not even that enjoyable for most women. John Gray puts it this way: men want to feel needed--women want to feel cherished. That's a good way of describing the differences. Widowed men are another interesting category, usually older than divorced men, Healthy, active widowers have demographics in their favor. Women tend to live longer than men, and there is always a big selection of widows seeking healthy, active males for companionship. Thus, a widower in good health is likely to have many potential partners to choose from.

Much of what goes on within the Catholic priesthood with respect to male sexuality remains a mystery to me. Not only do Catholic priests take a vow of celibacy, the Catholic church continues to have very "traditional" attitudes toward birth control, masturbation etc. But Catholic priests do have "housekeepers" and I am aware of an instance where a live-in housekeeper provided services that went well beyond cleaning the rectory. How commonplace this is, however, I have no idea, as Catholic priests have not exactly been writing to the "Male Sexuality Questions Answered " web page. As a practical matter, the Catholic Church's position on issues such as masturbation and birth control is sadly outdated. According to one of my readers, materials supplied to adolescents by the Catholic Church indicates that the Church regards a "wet dream" as normal, that is, not sinful. That is certainly good to know! My medical guide's assertion cited earlier that "every viable male should have a periodic release of sperm" in order to maintain good general health gives pause for concern about the general health of priests who follow the doctrine of the Church to the letter. I would welcome additional letters that are able to fill in some of the details as to what actually goes on here.

Men who are away from their wives or other sexual partners for long periods of time face a special set of problems. Most men, in their 20s and older, I believe, gradually adopt an increasingly "regular" schedule for orgasms, the average probably being about every 2-3 days (though I get many letters from men who claim to be on a long-term schedule far more frequently than that). Once his schedule gets set in place, most men deviate from it only infrequently. Illness & stress may have an impact on the schedule, however. Business travel is a form of stress. While sexual partners at travel locations are not uncommon, I suspect that is not the primary sexual outlet for most of these men "away from home." Masturbation, or even mutual masturbation with the wife (or other "at home" sexual partner), over the phone is probably quite common. I would be interested in hearing more from married men, in particular, who are willing to talk about this. Every man seems to work out an individualized system that works in his special situation.

Men without sexual partners who are living with family members (parents, roommates etc.) face special problems. Masturbation is probably the primary sexual outlet, but masturbation cannot be pursued with abandon if the man is constantly concerned about being "discovered by a roommate or a family member." This sometimes makes it difficult to establish a regular "schedule" and in general getting adequate time to really "enjoy" the activity. I have visited with many gay men who do not have sexual partners. While there clearly is a subset of gay society that is hopping from one partner to another, my e-mail indicates that this is probably no different from the sub-set of the straight population that is doing the same thing with female partners. Gays are just as varied in personality, outlook, and attitudes toward sexuality as are straights. In looking for stable, long-term relationships, many gays go through periods of their lives in which they have no sexual partners. Gay men deal with this situation the same way straight men do: then tend to masturbate a lot. One difference I note is that the gays I have visited with are much more open with respect to not only admitting this but also in describing the specific techniques they use. Furthermore, gays seem to be a good deal more creative with respect to thinking up new and exciting methods. Straight men tend to be hung up on the notion that if they mention this, whoever they talk to won't regard them as "real" (that is, straight) men, and so it's best not to say anything. Gays frequently trade information with each other about interesting masturbation techniques, seeing this as simply a manifestation of their overall interest in other men (newsgoups that cater to gays are filled with this information: Straights seldom trade such information, for fear of how their interest might be interpreted by others. After all, they don't want to be called "jerk-offs," a very derogatory term! As a result, straights generally lack the information on masturbation techniques gays routinely trade. Men who remain single and choose to avoid sexual relations make this choice for a variety of reasons. Any intimate relationship, to a certain degree, is manipulative. While men manipulate women, women, on average, are probably more adept at psychologically manipulating men to get what they want. This goes right back to the "sex is just part of a larger package of need" that provides an overall explanation for female attitudes and behaviors toward men. Women's magazines are filled with articles that help women develop techniques for getting what they want from men. The issue is not the question of whether women manipulate men. (This sounds chauvinist, but they do! Remember, however, I also said that men manipulate women to get what men want, so at least I'm a "fair" chauvinist). Rather, the issue is how individual men react to the female manipulation. A lot of married men regularly complain to their male friends that they are being psychologically manipulated by their wives. But individual men react and deal with this differently. Many men see the manipulation as simply the "price" they must pay in order to get what they want out of the relationship (for example, sex). These men don't even realize that this is (or was) a choice they made. For many men, this psychological manipulation by their female partners is so much an every day part of their lives that they no longer even think of it as psychological manipulation. Other men "fight back" to a certain degree, by refusing to do the things their wives suggest. But this strategy is fraught with dangers. Many women are very adept at withholding "important things" in an effort to regain control over what they regard as a deteriorating situation. The men who fight back too strongly or too frequently generally end up in divorce court.

Many men who remain single and who choose not to have intimate relations with a woman simply conclude that the price of intimacy (that is, a lifetime of female manipulation) is too large a price to pay. Everything comes down to a simple choice. Is it worth it to give up the freedom of a single life in order to find sexual intimacy? While most men say yes, some men conclude no. There is nothing wrong with that. But to compensate, these men may take masturbation activities to a higher level than their counterparts who have made other choices. With time and privacy available, why not experiment a bit! Keeping the sexual equipment in good order is an excellent idea for good general health as well. Perhaps I'm being a bit unkind here, but every man has the opportunity to make these choices. Many men make them without even fully recognizing the options that are available. Sexual intimacy is an explicit choice to be made.

Male Sexuality In the 21st Century: Where Do We Go from Here?Sexuality issues change with each generation. In the 1950s and 60s, it was the development and increasing use of the birth control pill, making premarital sex increasingly widespread. This evolved into the free love culture of the 1970s. Sexually transmitted diseases were of no particular concern, because they could be controlled by ever more powerful antibiotics and other miracle drugs being developed. Anything was possible! Sex could be had without love or guilt. AIDS changed all of that. Suddenly free love was far more problematic. The 80s became a decade of increasingly sober attitudes toward sex, for both men and women. The miracle drugs were not all they claimed to be.

Other changes have gradually occurred over the past three or four decades. The divorce rate gradually increased. Fewer and fewer children grow up in families were both parents are present. Fewer still grow up in families where the parents are in a loving, caring stable relationship. What chance do these children have in developing loving, caring relationships themselves? Certainly less of a chance on average, than children growing up in stable relationships. Other hot-button issues appear to be increasing concern. Despite the widespread availability of birth control measures, the abortion rate is still very high. Illegitimate births are up, even in states widely known for conservative values. The groups opposed to homosexual rights and the groups attempting to protect and increase homosexual rights under the law are shouting at each other. Religious groups that preach love and acceptance of every other kind of sin often appear to place homosexuality in a special place. Ours is a throw-away society. Both parents increasingly work, and family meals consist of take-out pizza on paper plates. Instead of buying an automobile with the intent of changing oil regularly and keeping it in top running condition for ten years or more, automobiles are leased, and traded in after three years. The notion of stability and continuity is lost. The same is true of relationships.

Instead of couples attempting to make repairs in relationships, they simply divorce and try again with someone else. Fragile relationships are consistent with a hedonistic, throw-away society with a focus on immediate fun rather than long term well-being. Perhaps we should be encouraged that divorce in now considered to be socially acceptable not a negative mark. Perhaps many more couples in the 1950s and 60s were living in unacceptable relationships that were held together only because of the social stigma attached to divorce. Perhaps. But somehow, I doubt it. As the millennium approaches, these issues are not going to go away. Some of them may actually increase in comparative importance. The issues surrounding abortion and homosexual rights, for example, have become so emotional on both sides that I see little potential for progress. And the rhetoric gets increasingly strident, as each group attempts to shout down the group they disagree with.

But there is hope. I am increasingly optimistic that adolescents are getting more solid information about sexuality than ever before. But I too worry about access to information that is inaccurate or misleading. When I set up this web site, I was somewhat concerned by the possibility that some teenagers would get access to information here that they somehow shouldn't have. I considered an elaborate system of electronic "gates" warning of the explicit content of some of the material discussed here. But I finally concluded that there was nothing on this web site that was inappropriate for anyone to know. This site is not easy to find. To find it, you have to be proficient at using the internet and the currently available search engines. Anyone smart enough to find the site is old enough to read its contents. I know some parents worry about their children's access to sex-related materials. I've heard from them. But in many ways, the internet is a far safer and better way to learn about sex than the traditional sources. And the information is likely more accurate too. So I'm reasonably confident that ever brighter teenagers will go into relationships better informed than ever before. Information leads to responsibility. Information is also valuable in developing understanding and reducing prejudices, regardless of who they directed toward or for what specific reason. So, in the end, I'm hopeful. And I'm hopeful that increased availability of frank, open information will be valuable in smoothing out the rough spots in adult relationships as well. We will see...

When other people travel, the process of getting to the destination may become as important as what happens at the destination. A few people even travel from place to place without even being concerned about reaching a particular destination. For these people, the real enjoyment of the trip is not what happens at the destination, but all the different experiences along the way. Some men, see the sexual experience in much the same way as travel is seen by the destination-oriented person. For them, the events, sensations and feelings leading to orgasm and ejaculation are of little importance, except that they are what leads to the "big payoff."

For other men--men whom I believe, on average, enjoy their sexuality far more than the "destination-oriented" men--the feelings and sensations involved in getting to the destination (the destination being orgasm and ejaculation)--take on as much or more importance than the orgasm itself. In short, these men are maximizing what they get from the total sexual experience, not just the experience in its last stage. An analogy may be helpful with respect to other kinds of sensations experienced by the human body. People who enjoy eating at fine restaurants are constantly bombarding their taste receptors with a continually changing collection of new, different and exciting sensations. Many human beings often get quickly "bored" if their eyes are not bombarded with new and different visual stimuli. Hence, the popularity of television!

Sexual feelings and sensations are not unlike the sensations of vision and taste in this regard. There is a constantly- changing panorama of sensations available to us, that change from one moment to the next during periods of sexual arousal. Men must simply learn how to take advantage of all of this.

Many men believe that it is somehow "unmasculine" to take advantage of (take time to "enjoy") these sexual experiences that occur prior to orgasm. They may have been taught at an early age that masturbation is somehow wrong, that is, either sinful or harmful to one's health. Young males are usually not reluctant to admit to each other that they enjoy "being" with a girl. But any discussion of sexual activities that do not involve being with a girl is considered inappropriate.

These same men bring these views into their adult relationships with their partners. Orgasm and ejaculation becomes the focus of their partner-sex as well, rather than full enjoyment of all aspects of sexual feelings.

As indicated before, arousal normally starts with a triggering mechanism. Boys learn at an early age that there are some arousal triggering mechanisms that are "ok", that is, socially accepted, and arousal triggering mechanisms that are "not ok." Arousal triggering mechanisms that are considered socially acceptable generally involve visual stimuli by a member of the opposite sex. In our "predominately straight" society, arousal that is triggered by a member of the same sex is not considered socially acceptable. Gay men have coped with this by forming separate (parallel) societies.

In addition to the problem faced by gays, there are many other arousal triggering mechanisms that work quite well but are not exactly coffee-room topics of discussion among the majority of men. For example, a close-fitting garment, a hand-held vibrator, an experience involving being "restrained" (bondage experience) or even simply a thought that is found to be sexually arousing. Most men are very embarrassed to acknowledge that these triggering mechanisms--those which do not involve visual or tactile stimulation by a woman--even exist, let alone spend time to learn how to take full advantage of them. In addition, while the vast majority of these arousal triggering mechanisms are quite harmless, sadly, several forms of illegal or otherwise inappropriate sexually deviant behavior have their origins here as well. Men often have questions that begin "Is it normal to be aroused by ___________ (Fill in the blank). I tell these men that if it's not illegal nor causes harm to someone else, then its "ok" and "normal."

Once the arousal has begun, there are physical and psychological changes that take place in men. As outlined earlier, typically, an involuntary message is sent from the brain to the nerves that control a series of valves on the veins by which blood is drained from the penis. At the same time, blood continues to enter the penis through the main artery, the heartbeat rate increases, and blood pressure rises. With blood flowing in faster than it is returned, the penis starts to become erect. When the penis is flaccid, touch seems little different than touch on any other part of the anatomy. But as erection starts to take place, the nerve endings concentrated in the penis start to become more sensitive and pleasant to the touch. Sexual tension has started. The first sexual feelings are rather unfocused, but as arousal begins, the man's attention increasingly is focused on the sensations emanating from the groin area. Many men believe these sexual sensations occur only in the penis, but there are many other places in the groin area that are quite sensitive as well. Equally interesting are the psychological changes that are taking place, something that few men acknowledge. At the initial stages of arousal, the man has no particular psychological "urge" to press forward to ejaculation. But as the arousal and erection continues, the psychological urge to press forward to ejaculation becomes stronger and stronger. This is the essence of building sexual tension. Psychologically, the man experiences the feeling of wanting more and more stimulation to continue and increase the intensity of the sexual feelings. The entire experience can be likened to the winding of a "sexual" spring. Increasing stimulation causes the "sexual" spring to be wound tighter and tighter, increasing the sexual tension. These sensations are extremely pleasant, but at the same time, the unreleased tension is also described as very "frustrating" by most men. Interestingly, some men describe this as a "delicious" frustration, and many agree that it is among the best, if not the best of experiences that life has to offer. The tighter the sexual spring can be wound, the more exciting the sexual "ride" and the more "extreme" the ultimate release will be. This is a human experience not to be missed. Fully recognizing this and fully taking advantage of these sensations and psychological urges in an effort to more completely enjoy them for a longer period of time without moving directly forward to orgasm is something that most men must learn. But the results are well worth the effort, both in terms of the man's own enjoyment as well as for the benefit and enjoyment of a sexual partner.

Testosterone Cycles, Refractory Periods, and "Wet" DreamsSome research has suggested that testosterone produced by the sex organs in males and the adrenal glands (on top of the kidneys) in females, has less to do with whether a man will become sexually aroused than is widely believed. Other recent research suggests that it is not testosterone, but a compound closely related to testosterone that is important. Ordinarily, after ejaculation, a man has no further interest in sexual activity of any kind. For a period of 10 minutes to perhaps more than an hour for some men, a man is physically unable to achieve either another orgasm, even if he is able to either keep or achieve another erection. The is called the refractory period.

The internet references I have checked suggest that the generally pleasant feelings of satiety, a lack of interest in further sexual activity and sleepiness following the male orgasm (which many women do not appear to fully understand or appreciate) are primarily liked to a chemical called oxytocin that is released during orgasm. If a man has an orgasm in the early morning hours, he may want to sleep afterward for an hour or two at minimum. Testosterone levels in the body tend to rise, not fall, for a period of time after orgasm. Sexual activity (intercourse or masturbation) prior to sleep in the evening may act as an excellent, natural sleeping pill. Most men have a daily cycle of testosterone levels that peaks somewhere between 4:00 and 6:00 a.m. This coincides with the period of time when many men have early morning erections, but some research has revealed that these early morning erections are more a result of involuntary reflexes during dream sleep--not the sexually explicit content of the dream nor the testosterone level in the body.

Most men, however, (including me) have certainly had the experience of abruptly waking from an erotic dream to discover an erection on the verge of ejaculation, and I question whether these research findings are completely valid. These involuntary erection (in younger men particularly, sometimes leading to orgasm) are a normal part of the sleep cycle for most men, and according to research, most men have perhaps three or four during each night. there are various theories as to why nature planned it this way. One theory suggests that this is a way the male penis "renews" itself with an ample supply of oxygen.

These erection cycles are quite normal. In fact a man who does not have such cycles is likely physically impotent. A simple test that is sometimes used is to wrap the base of the penis tightly with a strip of postage stamps before retiring. If the circle of stamps tears during the night, the man is not physically impotent. In the early years of post-pubescence, night-time erections are frequently accompanied by a full- fledged ejaculation, resulting in crusty spots on the pajamas and sheets in the morning. Most young men are somewhat embarrassed by this, but it is quite normal. Wet dreams gradually occur less frequently as men grow older, and masturbation is more frequent and sexual intercourse become increasingly important.

There is considerable discussion in the medical literature I have read with respect to the exact role of testosterone in the body. There appears to be broad-based agreement that testosterone (or perhaps compounds closely related to testosterone) are primarily responsible for sexual desire in both men and women. In short, individuals with low testosterone levels tend to experience lowered interest in sexual activity and have fewer sexual fantasies.

Testosterone is not necessary, however, for a man to be able to have an erection or an orgasm--it's just that when testosterone levels are low or absent, the desire to engage in sexual activities of any form will be reduced. This conclusion, however surprising, is supported by research involving men who have been castrated. These men are still capable of both obtaining erections and having orgasms, though the semen will, of course, contain no sperm. Hence, the interest in the use of castration as an approach for dealing with sex offenders.

I visited with a woman whose husband had been tested to have virtually zero testosterone levels. He still had normal erections, and they were having intercourse about 8 times a week. In other words, his ability to achieve an erection from physical stimuli was unaffected by the zero testosterone levels. However, he was not aroused and could not achieve an erection by any visual or psychological stimuli--photos of nude women, pornographic videotapes or anything similar. So the contention that testosterone is not necessary to achieve an erection, but is necessary if a man (or a woman, for that matter) is to be interested in having sex (the sex drive) seems to be consistent with this evidence. Since testosterone is produced by glands in addition to the testis, castrated males still have testosterone at some level, albeit probably lower than normal without drug therapy.

Most, but not all, of the testosterone in males is produced by the testis, although small amounts are produced by the adrenal glands, and testosterone is also stored in large amounts in body fat.

Unwanted Erections and "Bashful Kidneys"I have had a number of letters from men complaining of erections that occur unexpectedly in potentially embarrassing situations,for example, in a locker room, a public shower, while having a massage, or similar situation. Since your brain tells you when you are aroused, these responses are automatic and not under conscious control. The nerves running to the valves that control blood flow in and out of the penis are tied directly to the portion of the brain responsible for arousal and erection. Frequently, the situation in which the unexpected erections occur involve "novel" tactile stimulation from a massage, the texture or fit of an article of clothing, or something similar, There is no simple way to avoid the "problem" of an unwanted erection other than to avoid the stimulus that is causing it. The novelty of the situation is in part, responsible. Over time, when a man becomes familiar with the tactile sensations, the erections may subside, at least to a certain degree. It may be helpful to remember than men do not normally seek to avoid having erections, and erections should be enjoyed, not scorned.

Another common problem is the so-called "bashful kidney." A bashful kidney is a situation where a man has difficulty urinating in a public rest room, This problem was actually discussed in Ann Landers a number of years ago. The problem is exacerbated if the rest room is noisy, crowded, and the individual urinals offer little or no privacy. In addition, long trips in a car or on a bus or airplane seem to make the problem worse. Again, there is no simple solution as the muscles that control the flow of urine are not entirely under voluntary control. Over time, as a man ages, the problem tends to gradually recede. A rest room with private stalls may be the only solution.

Taboo Topics: MasturbationMasturbation remains a taboo topic within much of American society. Parents who openly discuss nearly any other sexual behavior topic with their children often are embarrassed when the subject of masturbation is approached. There are biblical passages which suggest, at least in some people's minds, that masturbation is sinful. And the "Boy Scout Manual" in the 1940s made note that masturbation was somehow harmful. Various physical maladies over time have been associated with or blamed on masturbation. Examples include pimples (nearly every adolescent boy has them, so there must be a connection) lack of agility and ability in sports, near-sightedness, and even blindness.

I remember discussing the subject with a medical doctor during the 1950s when I was about 13 years old. His advice was, "I'm not going to discourage you from doing that, but I don't believe that it is a good idea, either. I thought to myself, "That is certainly strange advice, I wonder what he means." But I was too scared to ask any more questions.

Fortunately, today most medical doctors are enlightened, and now believe that masturbation is not only normal, but perhaps even necessary for good sexual health, at least for post-pubescent males who lack other "sexual outlets." A medical text published in 1975, "Funk and Wagnall's Family Medical Guide," in its discussion of treatment for enlarged prostate, notes that "All viable males need to have a periodic release of sperm. Years of such abuse can have an effect later in life." The text does not give advice, however, as to the specific techniques that should be used to ensure that this periodic release of sperm takes place.

Who?Virtually all males masturbate, though some more frequently than others. Masturbation usually continues throughout adulthood, even when other forms of sexual activity are available. Most adolescent males are very embarrassed their self-stimulation activities. Only a small percentage of male adolescents discuss their masturbation even with close male friends, and most are terrified that their friends will find out. Many are also terrified that they will be " discovered in the act" by a parent. So, many adolescent males learn to get it over quickly, to minimize the chance of being discovered. Only later in life do they learn that the ability to delay orgasm is very important to learn in order to maximize sexual pleasure. So all the "quickie" techniques must be unlearned.

FrequencyAlthough as a man ages, the frequency of masturbation tends to gradually decline, but continues even for most married men. Some men believe they should not do this when they have opportunities for sexual activity with their partners and therefore try not to masturbate, in part, because they believe that masturbation implies partner rejection. As a result, they try to hide this from their wives (often by picking times and places where their wife is not around.

But I have visited with a number of men who have wives who are quite aware of their husband's masturbation practices and, indeed, encourage it. Some of the most happily married men I have encountered are those whose wives enjoy mutual masturbation, which becomes a regular part of the sexual activity. Part of the psychological problem that most men face is that this is a difficult subject to bring up with a partner, because any expressed interest in masturbation might be interpreted by the partner as a form of rejection. The men who have gotten past this point with their wives almost invariably report having a very satisfactory sex life. A favorite male sex fantasy is getting the opportunity to watch a woman masturbate, and many woman find watching men masturbate to be sexually exciting, once they get over any hangups with the basic idea. Unattached single men, and gay men, of course, tend to masturbate more frequently than married men. For gay men in a relationship, mutual masturbation is a primary sexual outlet, if not the primary one.

While it is true that some women my interpret their male partner's interest in masturbation as a form of rejection, other women may interpret this somewhat differently. By masturbating in front of the woman, the man is sharing the most personal of all activities. That a man is willing to do this with a partner is an expression of love, not rejection. Thus, mutual masturbation could be a highly erotic and loving activity for men and women. It could also be something regularly done at the initial stages of love making.

Masturbation TechniquesMen employ a variety of masturbation techniques. The simplest technique is to begin by simply squeezing the penis. Once the penis becomes semi-erect, stroking normally takes place, from tip to base. By concentrating at first on the base of the penis and avoiding the tip permits the erection to proceed and is a basic technique for delaying ejaculation.

The entire groin area, including the penis, scrotum and the groin itself, gradually becomes more sensitive to the touch. Once the erection is underway, many men enjoy gently pressing on and massaging the scrotum. Gentle touch anywhere within the area can be sexually exciting, and even on other parts of the body, such as the male nipples.

Some men prefer to masturbate while lying prone on a bed, with the underside of the penis rubbing against the bed. Many men enjoy masturbating using a lubricant, rather than dry. Pre-ejaculate is an excellent lubricant, although the supply may be somewhat limited. Hand lotion or vaseline can be used, though, since these contain oils, they are probably not the best choice if intercourse with a condom is to follow. A clear, water based gel, such as KY gel, is made for this purpose and does not destroy condoms.

Some men enjoy using devices while masturbating--a vibrator, a shower massage unit or similar. Many of these devices produce an interesting, though short-lived effect. A shower massage unit or tub jet, for example, puts stimulation on the penis such that the feeling is much like having a giant vacuum cleaner sucking the semen out of the body. The whole thing is over in about 30 seconds, even without much of an erection. Interesting, but not something one might want to do on a regular basis, Then there is masturbation employing articles of clothing, which can also be classified as a sexual fetish.

Taboo Topics: FetishesFetishes are actually quite common among males, although men who enjoy fetishes are often very embarrassed by their turn-ons. Generally, a fetish is any situation where arousal occurs as the result of an inanimate object, most often an article of clothing. Fetishes are normally harmless, except for the possible psychological harm for a partner who does not understand what is going on. Fetishes are virtually entirely a male domain, and few if any women can relate to enjoying anything similar.I do not know for certain if a majority of men enjoy fetishes, but certainly a large number of men do, and they are quite "normal." College students who engage in "panty raids" of women's dormitories are revealing a very mild, and perhaps "peer group-acceptable" fetish. Men who enjoy seeing women dressed up in clothing that is over the edge of feminine attire--4 inch heels, fish-net stockings etc, are probably exhibiting a mild fetish. Most men, however, see this fetish as part of their overall heterosexual interest in women, and few men would regard this as "abnormal." Transvestites--that is, men who are sexually aroused by dressing up in womens clothing, are sometimes treated by society as being abnormal, but many of these men are married to women and have otherwise normal sex lives. The only consequence of this fetish for many of these men is that they are sexually aroused by actually dressing in women's clothing.For a small percentage of men, however fetishes that involve women's clothing can ultimately lead to dissatisfaction with "being male." Given the amount of e-mail I've received dealing with issues related to fetishes, I conclude that they are far more commonplace than is widely believed--even among professional therapists. Interestingly, the e-mail I receive suggests that among the most common are those involving clothing items not even mentioned in most discussions of the topics found in books--in particular, underwear, swimwear and jock- strap fetishes, and even fetishes involving other mens clothing items, such as lycra cycling shorts or tight-fitting blue jeans. In most instances, the clothing item that is responsible is worn, and is used in conjunction with masturbation or other forms of sex play. A combination of texture, fit and appearance seems to be involved in these kinds of fetishes.

While surveys on this are difficult to conduct accurately, one clue as to how commonplace a particular type of fetish might be can be obtained from the Internet. Internet newsgroups generally form on topics where there is widespread interest. So far, there is an internet newsgroup that deals strictly with underwear fetishes; another that deals specifically with garments made with lycra (that newsgroup attracts both men and women);and a third newsgroup dealing specifically with jock-strap fetishes. All of these newsgroups are quite active in exchanging information and preferences about brands and styles of garments that are best for the purpose. Of course, there are newsgroups for many of the more widely known fetishes involving cross dressing and the like. There is even an internet site for those who get "involved" with plush (stuffed) toys! The list goes on and on! Just when you think you have heard it all, another, even stranger fetish pops up. For the men who have a fetish for blue jeans, a separate newsgroup has yet to form, so these men have been showing up on some of the other fetish-related newsgroups. A fetish based on a coarse-textured fabric. is somewhat different from fetishes involving lycra or silk garments, where the smooth, slippery rather than the rough-textured fabric plays a role. Also, many fetishes involve items of clothing normally worn in conjunction with sports activities, and there are small business operators who specifically cater to that market and sell products over the internet.

The recent popularity of boxer shorts made from silk is, at least in part, due to the fact that many men find the feel of silk against the skin arousing. Some men find the tight-fitting lycra or spandex compression shorts to also provide some interesting sensations in the groin area. Touch feels quite different through lycra than on bare skin. And there are plenty of fans of brief-style lycra swimwear. There are also mail-order clothing companies which cater to these kinds of interests. Those who have underwear fetishes appear to be about equally divided between those who have a preference for briefs, bikinis and thong-type underwear, and those who have a preference for boxer-style shorts. The group interested in boxer- style shorts seem disinterested in other underwear styles, and vice versa. There is considerable specialization among the various groups.

Those interested in jock-straps have strong preferences as well, The various brands of jock-straps available on the market are carefully evaluated with respect to how tightly they "fit" and the feel of the material and the straps as well as the particular sensations they are capable of producing in the groin area. Some brands are clearly preferred over other brands, and there is considerable discussion on newsgroups over the comparative advantages and disadvantages of each brand. A sub-group of jock-strap wearers are particularly interested in those which have plastic protective cups, such as those worn for sports requiring heavy protective gear. There are many different shapes and sizes of cups and each particular type has its own group of advocates. Some prefer the large cups often worn over clothing in sports such as hockey or boxing. Still others prefer tighter fitting cups that can be worn under other clothing items. Advocates of this form of activity claim that the sensations obtainable when even a slightly erect penis presses against a hard cup are quite enjoyable indeed. One unique activity engaged in my many men with underwear fetishes is underwear trading. This activity appears to take on a particular importance in gay society. The newsgroups are filled with requests by gay men to trade underwear, jock-straps, or other similar garments. Though there may be straight men who also engage in this activity,I have yet to hear from one, although some of the gay men I have visited with claim that their interest in underwear is incidental to their sexual orientation.

Among the underwear traders, there are specialists. Some prefer to trade underwear or jock-straps that are new, and still in the original packaging, much the same as someone might collect coins or model trains. They may catalog their collection in detail for other participants in the newsgroup to read. Other men, gays primarily, are interested in trading underwear, jockstraps or swimwear that are "used." A number of men have admitted to stealing (they call it liberating) these kinds of clothing items from laundry rooms, locker-rooms etc, when they are left unattended. Many of these men prefer, used, stained, garments, particularly if stained with semen. It's unclear as to whether the primary sexual interest is in the garment or the wearer. Garments from other gay men who are of a similar age and build appear to be most preferred. Underwear trading among gay men appears to be the first step in an internet dating ritual that, if the underwear seems ok, may eventually involve first a phone conversation and then perhaps actually meeting the underwear trader. In addition, many gay bars have underwear nights in which men dress up in underwear.

Based on the internet sites and newsgroup activity, it may appear that underwear and jock- strap and similar fetishes are largely a gay activity, but straights engage in these activities as well. However, gays usually seem more willing to discuss fetishes, perhaps because they see many of the fetishes as merely a part of their overall interest in other men as objects of sexual attraction. I have visited with very happily married men whose wives not only knew about the underwear fetish, but help their husbands pick out underwear that is particularly arousing to them! In these instances, the underwear was simply part of the overall sexual chemistry between the man and his wife. All of these activities are quite safe, harmless fun. The only down side is the potential embarrassment for the man who enjoys these sorts of activities should someone "discover" them.

Sexual Repression and Sexual Enjoyment: Now and ThenThose who visit primate exhibits at zoos are often amazed at the speed by which the sex act takes place:in some instances, less than 30 seconds from start to finish. I understand this varies somewhat by primate species, with the sex act taking considerably more time (more "monkey play") in some species than in others. The idea to drag out the sexual act into something that lasts much longer than a few minutes is uncommon among living things and is part of what makes us human. I've often thought about the concept of "sexual enjoyment" in various societies and for those who grew up in various families which have either quite restrictive attitudes or quite liberal-minded attitudes toward sexuality and sexual activities. I also like to think about this issue as societal values change over time, from the restrictive views of the immediate post World War II era, to the free-love era of the early 70s, to the more conservative know-your-partner views increasingly favored in an era marked by AIDS and other STD's.

An interesting question, I believe, is under what conditions do humans secure the greatest enjoyment from their sexuality. Consider first a family with very restrictive religious or other views toward sexuality. Are those living in such families actually experiencing less "enjoyment" from their sexuality. Those living in such families likely have less opportunity to date, engage in sexual intercourse and other forms of "partner sex may not be available at all." But under such conditions, whatever sexual activity does take place acquires a new meaning in terms of its importance. In addition, the "delicious frustration" of not being able to have an orgasm whenever one wishes in itself becomes a source of sexual pleasure. Or consider sexual attitudes during the 1950s versus currently with respect to the role of sex in dating behavior. In the 1950s, I gather, pre-marital sex was considered quite "wild" and not something "good" young men and women engaged in. By the 1980s, sexual intercourse was common after the second or third date. The attitude of the 80s seemed to be "sex first, we will get to know each other later on." Does this new set of attitudes mean that the Generation Xers are enjoying their sexuality more than those living in the 1950s. Somehow I doubt it. The attitude in which sex after the second date is expected puts enormous pressure on he psychological relationship between the two people. Women reach adulthood believing "that's what men are after." Men begin to think that "If I don't offer to have sex with her after the second date, she will think there is something wrong with me" (that is, she will think I must be gay or something!). It's no wonder men and women stumble into relationships they don't really want, and find out only much later (often after marriage) that they are "psychologically incompatible". Many of the ills of current society, illegitimate births, high divorce rates, spouse abuse, are linked to these so-called "modern liberal attitudes" with respect to the role of sex in a relationship. This idea goes right along with the "orgasm centered" attitudes many men have about their sexuality. Or consider the free love of the 70s, a period of time when young adults experimented a lot with promiscuous sex, drugs and on and on. Did sex somehow acquire more meaning because of the then-new liberal views that prevailed in this time period? Did the young people who became adults during this period really get more enjoyment out of their sexuality than did their parents? Again somehow, I doubt it. The freedom to do anything you want in the sex department does not automatically mean that the sexual pleasure quotient has increased. Could it be that men living in societies where intercourse is less free and frequent are actually getting more out of their sexuality than those men living in societies where sex is more readily available? The quantity versus quality issue thus reappears. These issues are certainly worthy of pondering. If our response to the AIDS epidemic has accomplished anything positive, it has focused our attention on the importance of a relationship in partner sex. It is not at all sad that humanity once again focuses on the importance of knowing very well the partner you have sex with. If this delays intercourse a few dates longer, so be it.

Sexual Orientation and Preference IssuesI have visited with many men who are well past their teens and are still quite uncertain of their sexual preference. I conclude that this is actually quite common. The media portray male sexuality as if most men are either straight or gay, with but a few men falling in a middle category that is potentially aroused by members of either sex. I have visited with many gays who were aware of their sexual preference at a very early age, perhaps nearly from the moment they realized they were male. Obviously there are many men who are clearly heterosexual, or straight, and have no same-sex interests whatsoever. However, I have visited with a surprising number of men where the preference is not nearly that clear. One book I have--Sexual Happiness for Men: A Practical Approach--that discusses sexual orientation issues lists seven different categories of sexual preference, depending on the relative arousal in and preference for same-sex versus different-sex activities. These categories are based on the original work by Alfred Kinsey (who, interestingly, was an entomologist by training). Using this categorization, bisexuals are only those who are equally aroused by both same- and different-sex activities, and thus have no preference for one over the other. Most men, however do have some preference for one or the other. Sexual preference is, at least to a certain degree determined by whether a man is aroused by a member of the opposite sex or by a member of the same sex. You don't get to tell your brain what you find arousing: your brain tells you! Very few straight men are so straight that there are not certain kinds of same sex-activities that are at least slightly arousing. Most heterosexual men, for example, would likely get a bit aroused if they were placed in a room with a group of other men who were all masturbating! Similarly, few gay men are so gay that they would not be aroused by any form of different- sex activity. Sexual preference for most men is just that, a preference. This preference is often expressed by who the man falls in love with, and while what (or perhaps who) triggers the arousal mechanism is important, other factors are also involved, and expressions of same-sex sexual interest are quite common in situations where contact with members of the opposite sex is limited (army, boys schools, prisons, etc). When the situation changes these interests may recede as well, and many of these men return to a heterosexual life. Once a man discovers an activity that he finds very arousing, other available activities that are less arousing normally recede into the background. Thus, if a predominately though not exclusively heterosexual individual determines that certain kinds of different-sex activities are highly arousing, interests he might have had in same-sex activities will likely recede. Psychologists refer to this as a "psychodynamic" situation with outcomes that vary depending on the available options.

While many gays seem convinced that theirs was not a choice, this is not always the case, and it is possible for a man with some same-sex interests to go through life as a straight. I'm convinced this is part of what makes "coming out" difficult for many men with an interest in certain same-sex activities, because making a final decision as to preference is often not easy, and is a decision that cannot be easily reversed. This struggle seems to be critical for many of the men I have been visiting with who are having difficulty in deciding what their real sexual preference is. It is not surprising that this can be a difficult situation: A man who has come out as a gay will have difficulty if he decides that he wants to attempt to begin dating women, for example. Men who do not appear to have a preference often face a lot of problems, and are largely treated as if they were gays by the straight community, but these individuals are frequently rejected by the gay community as well for not being truly gay or comfortable with their "true" sexual orientation. Some recent research has suggested that a much higher proportion of men can be aroused by same-sex activities and images than is represented by the percentage of men who actually go into same-sex relationships and live as gays. Most of the remainder of these men undoubtedly primarily if not exclusively live as heterosexuals. So being gay or being straight involves both the arousal triggering mechanism and the ultimate choice of a partner. Even more interestingly, these choices do not necessarily remain constant over time.

I had a chance to discuss sexual orientation issues with two different men, both in their 30s or 40s who both were married, and both, I believe, also had families. Both claimed to have "normal" sex lives with their wives. Interestingly, however, both of these men occasionally had same-sex encounters (not with each other but each with another man) leading to orgasm. The wives in each instance were apparently unaware of the gay relationship. The decisions these two men faced were not simple. In one of the two cases, I was able to help the man come to the conclusion that ultimately the gay relationship could mean that he would have to leave his wife and family. He ultimately reached the conclusion that this was not a price he was willing to pay for the same-sex relationship. In the other case, however, it was clear that the man was gradually leaning toward leaving his wife for the man he was having the affair with. I never did hear exactly what happened in this case, but I suspect very strongly that this man is no longer living with his wife. Despite the similar circumstances, each man likely made a different choice. I cite these cases to illustrate how complicated sexual preference can become!

PrefaceThis information is intended for those who wish to learn more about male sexuality--particularly information about topics that are considered to be too complicated, controversial or perhaps too embarrassing to discuss. The topics discussed here are loosely based on my responses to several hundred e-mail questions that have dealt with a variety of complicated but interesting issues related to male sexuality.

Basic Plumbing and ElectricalA suitable starting point is to begin with a discussion of how the basic plumbing and electrical system of male sexuality works. The plumbing and electrical system is complex, but very well designed for its purpose. Medical doctors refer to the electrical system consisting of the portions of the brain governing male sexual response and the associated nerve system as the limbic system. This electrical system connected to the plumbing system--a series of arteries and veins that control the inflow and outflow of blood to and from the penis, and also is connected via nerves to assorted glands.

Arousal, Erection and EjaculationMen often tend to consider these together, but, in reality they are separate but interrelated events, although ultimately related to each other. Any of these events can occur in the absence of the others

The Arousal MechanismSuppose that a man encounters something that excites him sexually. (more about what this might be later on). What happens? First, of course, messages are transmitted to the portion of the brain dedicated to sexual response. The man says to himself "I'm turned on" which is slang for sexual arousal. Many men believe that sexual arousal is always accompanied by an erection, but this is not necessarily the case at this first stage. The experience of being aroused is followed by electrical signals to two tiny glands that lie along the sides of the urethra where the tube that leads from the bladder through the tip of the penis. These two glands, called the Cowper's glands, are located inside the body directly above a point behind the scrotum called the perineum.

These little-recognized glands play a role in the male sexual response. They are primarily responsible for the production of glistening drops of a clear, slippery fluid sometimes called pre-ejaculate, but known also in slang as "ooze" or "precum". For many men, if not most, the first physical indication of sexual arousal is the formation of a drop or two of this fluid at the tip of the penis, even before erection occurs. Some men believe that when this fluid appears, they are already starting to leak ejaculate but this is not the case. This fluid acts as a lubricant for sperm and semen and lubricates the tip of the penis in sexual intercourse. It's pH level is quite high and it is very slippery. Research suggests that the high pH may help decrease the acidity of the vagina, thereby increasing the chance that the sperm will be able to fertilize the egg. Nature is very creative; it thinks of everything. Nature is at its very best when creating systems to ensure the continuation of the species, and the human system is one of its best and most elaborate efforts. The sexual arousal section of the brain sends signals to the cowper's glands (sometimes called the bulbourethral glands) telling them go into action. This is an automatic result of sexually-exciting stimuli, and thus outside of conscious control: the only way to stop it's production is to avoid the stimulus that is causing the sexual arousal.

These glands are present in many other mammals including the common livestock species. An internet resource dealing with the reproductive system of bulls, for example, indicates that the cowper's gland also secretes a similar clear fluid which is produced (and drips off the end of the bull's penis) during initial sexual arousal! Again, a function of the fluid is to reduce the acidity of the urethra, increasing the chance that sperm will survive.

A number of other things happen during the early stages of sexual arousal. First the man suddenly feels very good, psychologically. During arousal, the brain is flooded with natural chemicals that act similarly to drugs such as cocaine. These natural chemicals, called endorphins, make the man say to himself that whatever is causing the sexual arousal is very enjoyable and should be continued. If the sexual response is the result of observing another person, the man may make an effort to meet the other person involved.

Nature protects itself here and is very cunning. Nature's goal is to continue the species. If this is to occur, it's important that sexually attractive mates elicit a response that maximizes the chance that the two people involved will become better acquainted and perhaps eventually engage in sexual intercourse. (In case you were wondering, the arousal mechanism works identically for gay males, but the object of the sexual attraction here, is, of course, another male.)

Most men will produce pre-ejaculate when anything found to be sexually exciting occurs, perhaps even reading a sexually explicit story or watching a sexually explicit movie. The reason erotic books and videos sell well is because it often elicits this response in men along with feelings of psychological well-being, whether or not they have erections ultimately result in orgasm. There is no limit to the length of time that a man can be aroused, and throughout the man can continue to produce drops of pre-ejaculate. Pre- ejaculate may, of occasion, contain some sperm, and a woman can become pregnant even if actual orgasm and ejaculation does not take place. That is rare, although there are cases of this happening.

ErectionNormally, however, arousal is followed by erection. An erection of the penis occurs as the spongy tissues of the penis are engorged with blood. There is one large primary artery responsible for blood flow into the penis, but several veins that drain the penis of blood. When an erection is not happening, the inflow of blood and the outflow is maintained in balance and the penis remains flaccid. The valves (actually flaps, according to medical experts) that control the flow of blood, however, are opened and closed by nerves that run through the spinal cord to the brain. During erection, blood flows into the penis and holes in the spongy tissue in the penis fill with blood. At the same time, flaps in the veins leading out of the penis enlarge, cutting off the drainage. As a result, the penis fills with blood. As more and more blood flows in than out, the penis enlarges and becomes harder. Finally, veins in the penis are compressed from the increasing pressure from the erection itself. Not only that, the heart rate and blood pressure increase, the pressure of blood into the penis increases, keeping the penis the hardest. What can go wrong with the plumbing system? Several things. Those with spinal cord injuries are frequently unable to attain an erection because the nerves that control the valves in the veins and arteries have been severed. If these valves cannot be opened and closed an erection is impossible. As a man ages, the valves (flaps) controlling the veins that must be shut off may leak a bit, and not prevent the outflow of blood. And the blood flow into the penis may be restricted.

Also, as a man ages, the main penis artery may fill with sludge, reducing blood inflow. Smoking may contribute to this, as it does to the buildup of sludge in other portions of the circulatory system. Furthermore, alcohol use may decrease the ability of the nervous system to close off the necessary valves. That's why intoxicated men often cannot get and maintain an erection. Bicycle and other injuries to the groin area can be dangerous in that the main artery controlling blood flow to the penis may be squeezed shut, making a firm erection difficult or even impossible.

The size of the erection may be relatively unrelated to the size of the non-erect penis. Typically, those with smaller penises tend to enlarge to a greater degree when erect, so the differences in the size of the erect penis may not be that great. According to the book "Man's Body," the average flaccid penis is about 3 3/4 inches long with most falling between 3 1/4 and 4 1/4 inches, though a few fall outside this range. The average erect penis is 6 1/4 inches, with most between 5 and 7 inches, though a few are smaller and larger.

A somewhat tongue in cheek primary data survey is at How Do you Measure Up?

A Newsweek article (September 16, 1996, p. 73) reported American Geriatric Society average data on the angle of erection from horizontal of the erect penis by age. The data are as follows: Age Angle 2010 degrees up from horizontal 3020 degrees up from horizontal 40 1 degree up from horizontal 50 1 degree down from horizontal 7025 degrees down from horizontal

I wonder how data like these are collected! An article in Men's Health Magazine (June, 1996) indicates that these data are overly optimistic, and that the average erect penis length now widely accepted by doctors is 5.1 inches. This seems a bit short to me, at least for an average number, but if these data become widely known, most men may be happy to find out that they are "above average." Part of the problem is that scientific data on this is difficult to collect by other parties, and men, if they measure themselves in private, are perhaps sometimes prone to brag a bit. Furthermore, erect penis length varies with the degree of erection.

Past puberty, in the teen years, and perhaps during the twenties, it is possible to get a full erection without any manual stimulation at all. As men age beyond the 20s, this occurs less and less frequently and increasingly some manual manipulation of the penis is needed. As the penis becomes increasingly erect, the nerve endings located there gradually become more and more sensitive to touch. In general, the harder the penis can become, the more pleasant the sensations from the touch. Other physiological changes occur. As the erection grows, the heart and breathing rate increases. During the initial stages of arousal, before erection occurs, the testicles and scrotum feel quite large and soft, and are very sensitive to touch. Gentle pressure on the testicles with the fingertips produces particularly pleasant sensations. As the erection proceeds, the testicles change as well, increasing in size by up to 50% as they also fill with blood. The become harder and are drawn up to the body as the point of ejaculation becomes nearer and nearer.

Many men think that an erection must ordinarily proceed to an orgasm and ejaculation, but this is not necessarily so. By repeatedly massaging and then stopping the manual stimulation of the penis, a man can go through many erection cycles that do not necessary need to lead directly to orgasm. With each cycle, often the man can learn to take a bit more stimulation without ejaculating. Research indicates that stimulation of the septum, a portion of the brain known to be a part of the limbic system, results in the feeling of an orgasm, but this stimulation produces neither an erection nor ejaculation. These findings support the theory that ejaculation and orgasm, though often linked together, are, indeed, separate events. Interestingly, this research finding also lends credence to the theories of those authors who advocate the view that men can learn to have multiple, closely-spaced, orgasms.

Learning how to achieve an erection just below the level which will lead to ejaculation is an important part of sexual enjoyment. It is important for the man to learn how to read his body's signals that orgasm and ejaculation are near. Psychologists call the point where the man can no longer delay orgasm the "point of inevitability" There are several physical indications. First, the hole in the tip of the penis will become more slit-like. Precum production will stop. Generally if the fluid at the tip of the penis becomes milky, the point of inevitability is already past.

Learning how to lengthen the arousal and erection period while delaying orgasm is an important part of maximizing enjoyment from sex. As the erection proceeds, the physical sensations become increasingly more and more exciting, and the psychological pressure to ejaculate becomes more and more intense. The trick is to lean to keep the stimulation just below the level required for ejaculation while learning to deal with the increasing psychological pressure to ejaculate. Like driving a racing car closer and closer to a wall at ever high speeds, the psychological pleasure becomes more and more intense, the longer the arousal can be maintained without ejaculation, but the greater the enjoyment for the man.

Furthermore, the longer this stage can be maintained, the more powerful and enjoyable the orgasm will be for the man. Thus, developing skills for doing this and dealing with the psychological desire to ejaculate for as long as possible are essential for the full enjoyment of partner (and solo) sex, and this is what requires practice. Women usually require a somewhat longer period of time to become fully aroused, so being able to delay orgasm potentially increases the enjoyment of sex by both partners.

Many women believe that men are happier the more frequently they can have intercourse. This is not really accurate. What men truly enjoy is being aroused with their partner (and as their partner is also aroused) while both remain in an aroused state for a long period of time, delaying orgasm for as long as is comfortable and possible. A continuing theme of the story lines in erotic literature is a situation in which the woman arouses the man and keep him for a long time at a level just below what is needed to achieve an orgasm. It's important in achieving marital happiness for women to learn how to do this for their husbands,

All of the sections of the erect penis are not equally sensitive. Thus, by varying locations being stimulated, the man can perhaps delay orgasm.

Stimulation of the base of the penis, near the body, while pleasant, normally will not be sufficient to achieve orgasm. The underside of the tip of the penis, called the frenulum, is very sensitive to manual stimulation. If this area of the erect penis is stimulated very much, an orgasm (and ejaculation) will occur almost immediately. Thus it is important to not stimulate this region, at least not until late in the sex play.

There is a reason for this. During intercourse, when the man's penis is fully inside the woman's body, the tip of the penis will touch the cervix at the end of the vagina. Unless the man is deep inside the woman, the vagina is simply a hollow tube, and the tip of the penis is not touched. By ensuring that the orgasm takes place almost precisely when the tip of the penis comes in contact with the cervix, the sperm will have the shortest distance to travel to reach the waiting egg. Thus, a man's "reward" for placing the semen in the location that will maximize the chance that the woman gets pregnant (and the species continues) is the pleasant sensations that occur when the tip of the penis touches the cervix. In sex play, the man can reproduce these pleasant feelings outside of intercourse by touching the tip, particularly the underside of the tip, although orgasm and ejaculation will likely follow almost immediately.

Because of the sensitivity and pleasant sensations, the frenulum is often referred to as the "male G spot." A significant portion of the penis, perhaps one- third to one-half of it, lies inside the body. This portion of the penis also responds to manual stimulation. It can be felt and externally massaged at a spot called the perineum area, which is directly behind the base of the scrotum. This is a little-recognized but highly spot on the male body. This spot is sometimes referred to as the "second male G spot" though many men are not even aware that it is a sexually sensitive area of the body In addition to the possibility of externally massaging the interior portion of the erect penis, a bundle of nerves terminate here, and the main artery that is responsible for providing blood for erections runs through this area. That is why bicycle injuries may lead to impotency. Surgeons are becoming increasingly talented in repairing damage to this artery. In addition, inside, but directly above this area lies the cowper's (bulbourethral) glands, and it is likely that external massage of this area will to a certain degree stimulate these glands. The prostate is a little further up, but close by. A have heard varying opinions as to whether it is possible to externally massage the prostate by touching the perineum area, but I believe it is possible. Massaging the prostate, a walnut-size gland responsible for secreting most of the liquid contained in semen can be very pleasant, and some men do this by inserting a gloved finger directly inside the rectum, as the gland is located only about an inch inside.

Orgasm and EjaculationWith practice, a man can learn a degree of control over the point when he proceeds to orgasm and ejaculation. Some men believe that male orgasm invariably results in ejaculation, but this is not entirely true. Some men have learned techniques for having multiple orgasms without ejaculating. Many of these techniques involving squeezing of the urethra such that the semen is not allowed to leave the body. To me, this sounds potentially painful and perhaps even dangerous.

As indicated earlier, as the point of orgasm approaches, pre-ejaculate production will normally stop, and the hole in the tip of the penis becomes slit-like. The testicles become hard and are drawn up near the body in preparation. Breathing becomes heavier, and there may be involuntary contractions of major muscles (convulsions) throughout the body.

Finally, the psychological and physical pressure to ejaculate is released in a series of muscular contractions, usually about 8 major contractions spaced a second or so apart, followed perhaps by several smaller ones that can last 45 seconds or so. In essence, a pump has swung into action. Technically an orgasm is similar to a sneeze in that it involves a series of involuntary muscle contractions in response to an "irritation," though, of course, it is usually a good deal more fun. Semen consist of a mixture of sperm from the testicles and primarily fluid from the seminal vesicles and prostate gland, but also contains smaller amounts of other fluids secreted from glands along the urethra. Often the sperm is not very well mixed with the other liquids making the semen appear to have patches of cloudy and clear areas, and has about the same consistency as liquid dish washing detergent. (Somehow, I think of that every time I start my dishwasher!) Semen is usually creamy white in color.

Once the orgasm is complete, the valves which maintained the erection are opened, and the penis is drained of blood so that within a space of a few minutes it has returned to its flaccid state.

He Dribbles! He Shoots!Generally the more frequently a man has an ejaculation, the less force that ejaculation will have. This results in a shorter shooting distance. Most of the differences, however, appear to be both genetic and age-related. Some men are able to shoot longer distances than other men, and younger men tend to have greater force of ejaculation then older men. The book "Man's Body" indicates that after prolonged abstinence - more than three days - a man may be able to shoot 3 feet or more, but the average is 7 to 10 inches with more frequent ejaculation. If one is able to ejaculate two to three hours after his previous ejaculation, the semen just dribbles out. The ability to shoot long distances not only declines generally with age, but probably varies somewhat according to the hardness of the erection, too. There is also a wide variation in semen production, also according to the book "Man's Body", ranging from 0.2 ml to 6.6 ml.This same book notes that 3.5 ml is average after a few days without ejaculation--about a teaspoonful--while 13 ml has been recorded after prolonged abstinence. So this must be judged in relationship to the frequency of ejaculation.There is undoubtedly normal genetic variation as well. Interestingly, most of he fluid--60 percent on average, comes from glands called the seminal vesicles, whereas 38 % comes from the prostate, with the remainder from glands such as the cowper's. The prostate contribution is responsible for the characteristic odor. The fluid from the seminal vescicles is high in fructose, a type of natually-occuring sugar, which provides primary nourishment for the sperm in their travels.

Frequency of EjaculationAccording to a number of studies, Many post- pubescent young men report daily ejaculation, if not more frequently than that. This frequency gradually declines for most males to 2-3 time per week which is typical of men in their forties. But there is still considerable variation among adult men of a given age. The same Newsweek article cited earlier reports the following data on "average" frequency of orgasm per year by age. These data appear 'conservative' to me, but perhaps that is good if nearly all men, like the children in the mythical

Minnesota town, are "above average." Anyway, here is the data : Age Frequency 20 104 orgasms per year 30 121 orgasms per year 40 84 orgasms per year 50 52 orgasms per year 60 35 orgasms per year 70 22 orgasms per year

I wonder how many 20-year old men are content to "survive" on an average of fewer than 3 orgasms per week! Most older men should feel pretty good about their frequency of orgasm, based on these data!

Up or Down?Endless discussions have been taking place on the internet newsgroups with respect to the "best" position to wear the penis--that is, pointing either up or down. Obviously, it would be difficult if not impossible to wear the penis in an up position while wearing loose-fitting boxer shorts, but closer fitting briefs allow that as a possibility. Each side in the discussions has its advocates. (There are even a few men who prefer a position "to one side or another". These men appear to have distinct preferences for either pointing right or pointing left, but not both.) The underside of the penis,that is, the outer side when pointed up, is generally more sensitive to the touch. For some men, the sensation of cloth across the underside of the penis is sufficient to sustain a slight erection and the penis produces a larger "bulge" which might be "inadvertently" touched in the up position. Many people wonder why male ballet dancers as a group appear to be so amply endowed. Part of the answer is that the penis is positioned in an "up" position.

It is also not widely known that male ballet dancers wear a garment called a "dance belt" which is similar to an athletic supporter but holds the penis in the up position. Some of these belts are padded on the front so that some of the bulge is not actually penis! A "down" penis would ruin "the line" for male ballet dancers. Hence the popularity of the up position.

I recently received a letter from a former ballet dancer who claims that he, as well as the other dancers he knew, wore their penises in a "down" position. He argued that the dance belt does not force the dancer to wear the penis in the up position. So the discussion and disagreement on this topic continues.

A Curved Penis?I've received a lot of letters asking questions about whether or not a penis that curves up, down or to one side or the other is "normal." That depends. There is considerable variation in this that is considered quite normal. Remember, the penis consists primarily of spongy tissue that fills with blood when erect. Since a delicate system of valves (actually flaps) controls the amount of blood contained within a penis, only slight differences in relative pressures on each side could result in a degree of curvature.

Joel Block's book,(pp. 207-8; see reference list) however, describes a more serious problem, called Peyronie's disease, in which the penis becomes so curved that it interferes or even prevents intercourse. According to Block's book, the penis may be bent into a J-shape. The exact cause is unknown, but is thought to be due to a buildup of scar tissue.Vitamin therapy has been used with success in some cases, but surgery may be required. If you suspect Peyronie's disease, it's a good idea to check with a doctor. There is an internet reference from the National Institutes of Health on Peyronies disease with detailed information about underlying causes and treatment.

Lesions on the PenisI have also received questions regarding the presence of warts, pimples sores etc. on the penis or elsewhere in the genital area. I am not an MD, and could not diagnose these via e-mail even if I were. Any of these should be checked by a doctor. This is particularly true if you have been sexually active with a partner. These kinds of symptoms could be consistent not only with Herpes, but other, more serious Sexually Transmitted Diseases (STDs) as well. Self-treatment is not recommended. The STDs are cunning in that lesions often heal on their own, and yet the infection continues (as well as the possibility that the disease could be transmitted to a partner). This is nothing to fool around with, no matter how embarrassing you think a visit to the doctor might be.

Blood in SemenI have received questions regarding the significance of the appearance of blood in semen, particularly whether or not this is a symptom that should be checked by a medical doctor. The internet references I have checked on this topic with respect to possible causes are not necessarily consistent. The consensus is that blood which appears anywhere it should not ordinarily be should be checked by a medical specialist, including blood appearing in the semen. The internet references indicate that the common causes of this symptom include certain kinds of infections of the prostate or perhaps elsewhere in the urinary tract. Another possible cause is slight tears in the blood vessels or walls lining the urethra, which is the tube that carries urine and semen. This symptom could be a result of more serious causes as well, so it should be checked out by a medical doctor.

Sexual Tension and Sexual FeelingsA lot of men are very "orgasm-centered" in their sexual lives. By that, I mean, a focus on orgasm and ejaculation becomes important to the point where many men do not fully notice the sexually-related sensations prior to orgasm. As a result, many men do not fully appreciate or even experience these sensations. Men may find these statement surprising, believing that orgasm and ejaculation is what "sex is all about."

An analogy may be drawn to differences in behavior among people who travel. Some people are very focused on getting to their destination, believing that whatever favorable experiences are to be had will be found at the destination. These people often do everything possible to make travel to the destination as unimportant as possible. If they drive, they drive over the speed limit, stopping only for lunch breaks at drive-through windows, so that they can get back on the road as quickly as possible, and not "waste time." These people tend to fly rather than drive, if possible, because it's faster.